Gifted Issues Discussion homepage Forums Twice Exceptional SPD and Vision Therapy

Heather, do your ds' VT sessions include any kind of Brain Gym (up and moving type) exercises, Bal-a-Vis-X, or anything like that? This is just me totally guessing from thin air, but fwiw - here are a few more thoughts -

Our sensory dd had really low tone in her trunk when she was younger (still does but she's not quite as squirmy as she used to be, now she mostly slouches....). Her VT therapists always start off her sessions with a "cross-walk" where you step up high like marching and touch the opposite hand on the knee and follow a type of figure-8 path. There are a few other exercises mixed in between that have her standing up and doing Brain Gym-like activities, and I think that helped her not get overly stressed from eye strain etc.

They also have exercises they do on a mini-tramp - where she jumps and holds out her arms after a pattern that the therapist shows her. Another thing they do which she like is the Bal-a-Vis-X - it's basically just rhythmic and patterned bouncing of small balls. I think having exercises like that tossed in between the other types of exercise (where she is looking at paper up close, trying hard to match letters etc, or staring at the computer screen) helped reduce her overall sensory strain during the therapy.

They also have her sit on a bouncy ball while she does her VT.

Another thought might be to try just one type of VT exercise at home for awhile - just a few minutes each day - if you can find something that just by itself doesn't bother your ds too much. Also maybe consider just giving the VT a rest for now and trying again in 6 months or a year when your ds is a little older and might be more able to communicate what he's feeling and seeing, and also after he's been in OT longer and maybe made more progress with it.

The test I mentioned that discriminates between visual and fine motor issues is called the "Beery VMI" (VMI stands for Visual Motor Integration) and I think that there are OTs who can also administer it as well as psychologists. I wouldn't honestly worry too much about whether or not the person administering the test works with a lot of gifted children - I think in your situation I would start by first thinking through the things you see impacting your ds - does he seem to have difficulty with fine motor tasks? Vision-related tasks? Some of it might not be obvious of course, but think through what you see in everyday life and try to relate that back to the dips in scores on the WISC. If you think there is a possibility of fine motor challenges in the mix, ask his OT if they can do an assessment such as the Beery VMI to tease out what's up.

I'll also add that VT doesn't necessarily cause overnight changes, particularly if it's not a huge issue that is being worked on to begin with. And it's hard work. I think Zen Scanner is right on re the possibility that what you are seeing makes sense as his brain is being retrained to use vision to manage physical coordination.

Best wishes,

polarbear

Our son is scheduled for VT for the first time next week.

He's not been diagnosed with SPD, and I don't know how he's going to react, but he has had a long history of sound sensitivity, and recently he's been complaining about light sensitivity.

According to the doc, the outlook for his VT is excellent. (Pun intended.)

I hope the sensory melt-downing is a temporary hurdle for your DS, Heather123.

Just curious what kind of eye doctor you are taking him to? How do they know he is suppressing vision in one eye?

My DS had a traumatic brain injury from an accident on New Years Eve (at age 5 1/2) which resulted in a sixth nerve palsy and almost total loss of tracking ability of his right eye for months. His right eye was stuck in the corner by his nose. He had to wear an eye patch on his good eye for 6 hours per day, and when he didn't have the patch, he had double vision at all times--so for instance he would see two TV's side by side or two books or two of every person. Strangely, we saw almost no change in his behavior or abilities. There may have been a small decrease in fine motor. He has developmental coordination disorder, so probably had some issues with sensory integration and visual tracking all along, but the results of the accident were extremely severe in terms of his vision, and his eyes were very obviously misaligned for months. He said that he liked having double vision and it didn't bother him. When he read, he said there were two books side by side and he just looked at one of them. I took him to a neuropsych who did the WISC IV. At the time this was done, his eye had started gaining some motion and was tracking past the mid-line but i don't think it was completely normal. His overall non-verbal IQ was 99.7 percentile, but he only got a 13 on block design, which is timed. The neuropsych attributed this to his poor fine motor skills. He scored below the 1st percentile on a timed pegboard test. One could argue he was scoring that low on the pegboard and block test because of his vision, which I guess is possible, but he scored really low for fine motor coordination before he was in the accident. I think he may have had issues with visual tracking before the accident though, too, but not nearly as severe. His processing speed I think was an 11 or 12, so slightly above average.

I took him for an OT and PT assessment and even though his eyes "look" normal now, rather than completely crossed, they say he can barely track moving objects at all. I don't know if this is from lingering effects of the sixth nerve palsy, or if he was always like that due to developmental coordination disorder or hypotonia. I have an appt. to take him to a neuro-opthamologist since the regular pediatric opthamologist thinks his eyes are completely normal now (despite what the OT and PT say). I'm hoping that a neuro-opthamologist will be able to tell me what's going on with the poor eye tracking and help him somehow. His depth perception is impaired and I'm hoping if he learns to track, it will help some of his fine motor skills and reading. I'm curious what vision therapy entails. I just thought I'd share that my son's eye was massively messed up, it happened very suddenly due to being in an accident, and it must have been hard for him sometimes wearing a patch and sometimes not, and looking at the world where everything was double, but it seemed to have little effect on him or his mood or behavior. Every once in a while he complained about getting a headache above one eye and he still does when he reads.

blackcat, my dd11 had severe double vision until she went through vision therapy the first time at age 8. We don't know when or how it started, but she never once told us she saw two of everything - she just accepted that as normal, and until she was tested by the developmental optometrist and we found out, I don't think it occurred to her that everyone else wasn't also seeing double. She had amazing improvement from her first round of vision therapy, most likely because her double vision was due to weak eye muscles and the VT strengthened them. Over time, after she'd completed her first round of VT, she slowly began seeing double again - and again, she didn't bother telling us, just accepted it. For me, that would be beyond frustrating but for whatever reason, for our dd, she just accepts it as part of life and doesn't get upset or worked up over it. Note - now that she's had successful VT and seen the world without her double vision, she does know she'd rather only see one of everything but she'll still not tell us if she's seeing double, or if we ask and she is she'll just say "yep, I see two" very nonchalantly as if it's not a big deal.

Our developmental optometrist told us that for some kids (including our dd) who have double vision, the brain will actually shut off vision in one eye as a way of coping with making everything not-double. We were able to tell when our dd's brain would do this because she would tilt her head in a funny direction when she was reading or writing or trying to watch tv or look at something up close.

I don't know if VT would help your ds - our eye dr feels it's really helpful for issues related to muscle weakness but not successful for other issues - but I think the exam that DO's give when a child is first assessed for vision therapy screening might be helpful even if VT wouldn't - the assessment will tell you how your ds' eyes are working together - which is very different than a typical eye dr exam where you find out how each eye is functioning individually. You'll find out whether or not eyes are tracking, how much peripheral vision your child has, etc.

Best wishes,

polarbear

Polar bear I have this clear memory when talking to the therapist about DDs BO assessment and they mentioned the turning the head thing to turn off one eye. DH piped up "Oh yeah I've always turned off one eye to read numbers, especially in colums"... And it did not once occur to him to mention this to me, even when we were setting up aptts for assessment...Our kids really won the genetic lottery with he and I as parents.

Thanks for the input. The regular opthamologist insisted he wear a patch on his good eye (with at least 3 every day with no patch) because she was worried about amblyopia and that he'd lose his vision in his bad eye. I think he did lose a small amount of vision in between the time of the accident and when we started patching, but then regained it. Small kids (probably toddlers-preschoolers) are especially prone to losing their vision.
The OT told me to take him to a neuro-opthamologist and I'm hoping she is helpful. If not, I will try a developmental optometrist. Since there is a brain injury, I'm worried there will be information that an optometrist wouldn't be entirely familiar with. The OT said that he should get vision therapy but most insurance plans won't cover it, so they will try to work on vision in regular OT first. I remember last summer, before he was even in the accident, his old OT mentioned that he has eye tracking issues and I wish I knew whether they are worse now. She didn't seem to think it was a big deal and didn't work on vision in therapy so I'm guessing it's worse now. The new OT said that since he had double vision and was patched for months, he probably learned to use one eye at a time and therefore doesn't know how to use them together anymore. So, he becomes disoriented when looking at a Where's Waldo book and he also tends to skip words/lines when he reads.

My pg ds7.5 was born with a tbi (severe plagiocephaly), torticollis (neck/head tilting), low tone, severe SPD, and other stuff. He wore two helmets as a baby and had tons of therapies, including 2.5 yrs of vt between 4-6 yrs old. This past year, he was in neurofeedback, which helped address some SPD issues.

There was a period with VT when my son was quite dysregulated and out of sorts. He then swung around and settled down.

It took a long time to address his visual perceptual issues due to the torticollis - and since then I've learned the tbi too. NO one had mentioned that the tbi would have affected his vision, though this is quite dumb since my ds's head was severely 'misshappened' when he was born. Years of pt and ot helped, but vt made a dramatic difference.

Blackcat - I don't know how many behavioral optometrists are familiar with tbi. I do know that there's few who know about torticollis and the ramifications of head tilting or having visual deficits as a result. I used to talk about this things with my son's former behavioral optometrist in NY.

Yes, most plans do not cover vt. We paid for vt out-of-pocket and it cost us a bundle. Ditto for neurofeedback and water therapy - which I would also recommend for tbi. However, I had no idea my son was pg (bright yes, pg no) before my son had vt. The results were dramatic and I would do it again in a heartbeat. He absolutely needed the vt.

I know my son's former behavioral optometrist in NY does treat patients long-distance. We continued to do his program and consult via e-mail after we moved back to MA.

My son's seen two neurofeedback providers this year due to the insurance issue. One didn't take our insurance and cost us a fortune. We then switched and found a neurofeedback provider who did. So I completely understand with the expense for these treatments.

Zen Scanner- If block design is timed, that would expalin a lot. He hates anything timed and it freaks him out. The tester said that he would find the right design, but not realize it was right, and keep moving things.

polarbear- Sounds like you had a great VT! Our OT does a few of those things, but they don't do anything at all like that in vision therapy. The do some things with different shaped blocks, he does something on a large computer screen, and then something with little blocks with letters and numbers. They said he does okay, until he has to think while he using his eyes, so they will quiz him on math while he does the exercises. He hates it, but it's good for him! I have to ask them to let him get up and move around in between things beause he just can't sit still that long. I've been looking into Brain Gym and I'm thinking I should incorporate some of the exercises at home. You had some great ideas- thanks!

Ametrine- Good luck with your DS and vision therapy. Let us know how it goes!

blackcat- wow, you have been through a lot. I really hope you can find someone who will be really helpful for you.

Mumof three- My DS does the same thing. That's why they missed it during the first eval. The second eval he asked if he always saw the cross, and he said, "no, but I can make myself see it if I tilt my head, squint a bit, and change the way I look at it. I thought that's what you wanted me to see."

cdfox- thanks for your input. It's helpful to hear so many experiences.